Computed tomography angiography (CTA) has been proposed as a less invasive method to exclude obstructive coronary artery disease (CAD), but no consensus has been achieved about its clinical role in different patient subsets. Now a new report published in JACC from the CORE-64 (Coronary Artery Evaluation Using 64-Row Multidetector Computed Tomography Angiography) study shows that CTA may not be…

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An epic battle comparing the two most potent statins — the reigning king atorvastatin versus “gorilla statin” rosuvastatin — has ended with a quiet draw. Results of SATURN (Study of Coronary Atheroma by InTravascular Ultrasound: Effect of Rosuvastatin Versus AtorvastatiN) were presented at the AHA on Tuesday and published simultaneously in the New England Journal of Medicine. Stephen Nicholls and colleagues randomized…

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A small but significant number of symptomatic patients with calcium scores of zero have obstructive coronary artery disease (CAD), according to a new study published in the Journal of the American College of Cardiology. Todd Villines and colleagues studied 10,037 symptomatic patients without known CAD enrolled in the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: An International…

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Following coronary revascularization, patients are more likely to undergo cardiac stress testing if their physician has a financial interest in the test, according to a new study published in JAMA. Bimal Shah and colleagues examined insurance data from 17,847 patients who underwent revascularization, dividing their physicians into three groups: those who billed for technical and professional…

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Just as the great voleur Willie Sutton robbed banks because “that’s where the money is,” why don’t we just look for coronary artery disease (CAD) directly in the coronary arteries? At the ESC meeting today in Paris, Bharati Shivalkar of Belgium reviewed the assessment of CAD utilizing coronary CT angiography (anatomical)  vs. the usual standard of care,…

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In a study published online in Archives of Internal Medicine, John McEvoy and colleagues examine the impact of screening low-risk patients with coronary CT angiography (CCTA). They compared 1000 South Korean patients who underwent CCTA with 1000 matched controls. CCTA identified 215 people with coronary atherosclerosis. At 90 days and at 18 months, statins and…

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A new study raises the possibility that the radiation dose for MPI SPECT imaging can be reduced by half without sacrificing image quality, according to Dr. Nili Zafrir, who presented the results of the study this week at the International Conference of Non-Invasive Cardiovascular Imaging in Amsterdam. Recently, software has become available that can reduce…

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Could the real curse of the mummy be coronary artery disease? Despite strict adherence to the original Mediterranean diet and a complete lack of tobacco, trans fats, and refined sugars, an Egyptian princess who died around 1550 BC is the first person in history to receive a diagnosis of coronary artery disease. A CT scan…

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The PROSPECT trial provides some interesting insights about the mechanisms of thrombotic coronary artery disease, but how, if at all, should it change practice? Here are what the findings do and do not demonstrate: What the PROSPECT study says: In ACS patients treated with PCI, major adverse cardiovascular events that occurred during a median follow-up of 3.4 years were…

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In this journal club, I compare the published data from an original trial with the authors’ conclusions in a substudy from that trial. Often, a substudy provides valuable insights that complement the initial trial findings. Sometimes, however, you need to look closely to identify the additional insight. Case in point: COURAGE. The Original COURAGE Trial…

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